Chiu Bo-Ya, Tseng Mei-Chih Meg, Liu Yen-Hsiu
Department of Primary Care Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 235041, Taiwan.
Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 100301, Taiwan.
J Eat Disord. 2025 Jun 17;13(1):115. doi: 10.1186/s40337-025-01319-6.
This study investigated the shared and distinct features of emotional dysregulation and impulsivity in women with bulimia nervosa (BN) and bipolar disorder (BD) as well as their relationship with comorbidity between the two conditions.
This study included data from 115 women with BN and 76 women with BD, including 37 individuals with comorbid BN-BD, from a psychiatric outpatient clinic as well as 72 healthy female controls. All participants underwent a diagnostic interview and completed several self-administered assessments of mood and impulsivity. Statistical analyses were conducted to compare mood and impulsivity across the BN-only, BD-only, BN-BD comorbid, and control groups.
The disorder groups exhibited significantly higher levels of affective lability, attentional impulsivity, sensitivity to punishment, negative urgency, and both internally and externally directed impulsive behaviors compared with the control group. Comorbidity with BN-BD was further associated with increased severity in anger, attentional impulsivity, reward sensitivity (fun seeking), and externally directed impulsive behaviors relative to the BN-only group. Among these shared psychopathological features, negative urgency was significantly higher in the BN-only and BN-BD comorbid groups than in the BD-only group, indicating its unique relevance to binge eating. Attentional impulsivity was the only parameter that demonstrated significantly greater severity in the comorbidity group than in both the BN-only and BD-only groups. This finding implies that attentional impulsivity is associated with an elevated risk of externally directed impulsive behaviors in the BN-BD comorbid group relative to the BN-only group.
BN and BD share overlapping affect dysregulation and impulsivity profiles. Negative urgency and attentional impulsivity may make major contributions to binge eating and external impulsive behaviors, respectively, in individuals with comorbid BN-BD. Our findings highlight the importance of targeting emotion regulation skills as well as behavioral control of binge eating and associated impulsive behaviors when treating individuals with BN and BD comorbidity.
本研究调查了神经性贪食症（BN）和双相情感障碍（BD）女性患者情绪调节障碍和冲动性的共同特征与不同特征，以及它们与两种疾病共病之间的关系。
本研究纳入了来自精神科门诊的115名BN女性患者和76名BD女性患者，其中包括37名BN-BD共病个体，以及72名健康女性对照。所有参与者均接受了诊断访谈，并完成了多项关于情绪和冲动性的自我评估。进行统计分析以比较单纯BN组、单纯BD组、BN-BD共病组和对照组之间的情绪和冲动性。
与对照组相比，疾病组在情感不稳定、注意冲动性、对惩罚的敏感性、消极紧迫性以及内外向冲动行为方面表现出显著更高的水平。与单纯BN组相比，BN-BD共病进一步与愤怒、注意冲动性、奖赏敏感性（寻求乐趣）和外向冲动行为的严重程度增加相关。在这些共同的精神病理特征中，消极紧迫性在单纯BN组和BN-BD共病组中显著高于单纯BD组，表明其与暴饮暴食具有独特的相关性。注意冲动性是唯一在共病组中比单纯BN组和单纯BD组都表现出显著更高严重程度的参数。这一发现意味着，相对于单纯BN组，BN-BD共病组中注意冲动性与外向冲动行为风险升高有关。
BN和BD具有重叠的情感调节障碍和冲动性特征。消极紧迫性和注意冲动性可能分别对BN-BD共病个体的暴饮暴食和外在冲动行为起主要作用。我们的研究结果强调了在治疗BN和BD共病个体时，针对情绪调节技能以及对暴饮暴食和相关冲动行为进行行为控制的重要性。
